Transition taking ages

[November Fox]

I know I´m not the only one whose transition is taking very long.

I came out in 2015 after three severe years of dysphoria (I had dysphoria before but not that bad). I have had some stuff happen to me as a child (abuse) and I initially thought that my dysphoria was due to the abuse, not gender identity.

Talks with a therapist here are mandatory in order to get HRT. The therapists are very invasive and want to know everything about you to "prove" that you are really trans, as you say you are. I understand their thinking but I think their methods are unethical. In my case they trigger old trauma that is better left alone.

I tried two different gender therapists and I hated them. Each wants to poke around in my past and in things that don´t concern them. Now we are in 2017 and I will start talks with a third but I don´t have much faith in it. I´ve been self-medicating since 2016 (it was my last option before suicide) and I´ve approached a surgeon to try and get top surgery without having to go through talks with a shrink, but it´s a complicated process.

I did not expect my transition to be so problematic. I did not expect it to be easy, but this is far more difficult than anything I could have imagined. Perhaps hearing from others who also are having a problematic transition, and whose transition is taking way more time than expected, could help.

[kelly_aus]

Your attitude is part of the problem..

Talks with a therapist here are mandatory in order to get HRT. The therapists are very invasive and want to know everything about you to "prove" that you are really trans, as you say you are. I understand their thinking but I think their methods are unethical. In my case they trigger old trauma that is better left alone.

Nope, they are not looking for any proof you are trans, just trying to ensure you don't have any other mental health issues.  There are other issues that can appear similar to gender dysphoria. Fairly standard practice for a well trained, experienced therapist, to not do so would be, in fact, unethical..

You only get out of therapy what you put in, so if you don't put anything in, how can you expect to get anything out if it? I did my legally required 3 months of therapy, thought all along that the time period was arbitrary.. But I worked with my therapist and dealt with the old crap, such that it no longer impacts on my life. I did my time, got my hormone referral and had the hormones in my hands 3 days later.. There's also a surgical referral on file for me, not that I ever plan to use it. So it took about 6 months for me to go from "Oh ->-bleeped-<-, I need to transition!" to starting hormones - I was already partially socially transitioned by then.

[Elis]

I think that seeing a therapist can be good idea in order to see if you have any major mental health issues that could affect transitioning but I don't agree with being forced to see one for multiple sessions even though you've run out of things to talk about and go over the same information repeatedly. I much prefer an informed consent route for HRT so the GP can determine if you've thought it through thoroughly and then you just get on with it. There's no evidence whatsoever of people regretting transitioning.

As for my transition the NHS health service is a joke. It's more than a year wait for any gender identity clinic you want to go too; so I had to go private (luckily I had a ft job at that time to pay for it) . But even going private I had to have 4 therapy appointments even though the initial consultation with the doctor he could see I've thought about it thoroughly for a while (3 years at that point and the only reason I hadn't done it sooner was bcos my dad is bigoted and judgemental). After that I managed to get my prescriptions from my NHS GP. But then I had to wait a year for my 1st appointment at the GIC so have had to pay further costs to have follow up appointments at my private doctor to review my blood test results. And at my 1st appointment at the GIC was told it would be a 9 month wait for a second appointment and you need a 2nd appointment for HRT or surgery. So having to go privately for top surgery.

I know I've been fortunate in many ways but it's been tiring having to negotiate through the system and not having the NHS be as helpful as it should be. Trans people are seen as the lowest priority to receive medical help even though this is supposed to be a socialist country whereby health care should be for everyone.

I don't mean this to come across as me having it worse than you btw,  this has just been my experience.

[Devlyn]

It sounds like they accept that you're transgender and that's why they're concentrating on other issues? Facing your past can be hard. I was molested as a young boy. If I couldn't acknowledge that and talk about it, it would mean it was still holding me back, right? And it isn't something that I wanted to talk about, but holding it in would have been worse for me.

When I went for hormones, the doctor asked how I came to be sitting in her office looking for HRT. I talked nonstop for twenty minutes about my life, and she said "You've obviously put a lot of thought into this, come back next week and we'll get you on a starter dose."

Hugs, Devlyn

[November Fox]

Thanks for your replies.

I don´t think you fully understand my situation though. I have had therapy for CPTSD for a long long long time. It is generally agreed that with CPTSD sometimes it is better to concentrate on the here and now INSTEAD of talking about it, since talking about stuff that happened ages ago (and that I have left behind me for the most part) triggers old traumatic experiences. It´s counterproductive.

I also consider it unethical because I have a perfectly good therapist who has already diagnosed me with gender dysphoria, but since she is not part of a gender-team, her verdict is considered "not good enough". I feel like this is BS. So no, I don´t think this mandatory therapy is good. Not at all, in fact.  Therapy sometimes can make things worse, and when you are transitioning, calling up old trauma can push you over the edge into depression and suicide.

I understand where you are coming from but I´m really tired of people telling me that therapy is a good thing in all circumstances. I´m a man, period. It´s got nothing to do with the past, it´s not that hard, and it is not something that is up for discussion. And yes, that attitude is exactly the reason why it is taking me so long, but I refuse to conform to ideas people have, when those ideas are incredibly damaging.

Then there is the fact that it isn´t just one talk they require. It´s  six months of mandatory therapy, plus the waiting time for the therapy (seven months), plus waiting time for hormones (two months), plus waiting time for surgery (eight months).

It´s idiotic. Any arguments to the contrary will not change my mind - I´ve been in this system for three years. @Elis I´m sorry it took so long for you too. I also much rather would go with Informed Consent. I hope it will get here some day.

[WolfNightV4X1]

Im a little confused, if youre already self medicating, does that mean you just need surgery?

Granted, getting it through prescription is ideal so going through the system officially is a good option. However, are you barred from any kind of surgery without the therapy? Is the surgery paid via insurance if you go through their hoops? If not, why wait on them if it's only a money issue? Are you not allowed to have top surgery without permission from a licensed practitioner?

I was under the impression that a lot of guys traveled to get their top surgery done at places that would do it. Most insurance companies seem to consider hrt and chest reconstruction "cosmetic" and will not cover it anyways, so for most its a matter of scheduling in an appointment and just doing it, I guess.



As someone who has done informed consent it's a huge relief and its a shame it isnt a little bit more widespread (seeing as there isnt harm in it, really). I also know someone who self medicated so getting their prescription through the doctor ended up being cheaper and more efficient.

[November Fox]

Hey Wolfnight.

- I have a diagnosis of gender dysphoria from my regular therapist. She is not licensed as a gender therapist. Her diagnosis does not qualify (sadly) to get hormones the legal way or get surgery.

- yeah, I just need the surgery. But I would also really like for my insurance to cover hormones. They don´t at the moment, because I need permission from the gender therapist in order for it to be covered. I also don´t have an endocrinologist. They won´t see me without permission from the gender therapist.

- I´m barred from having hysto and bottom surgery without the therapy. The therapist actually said that I was also barred from top surgery, but after writing letters to the surgeon I might possibly get top surgery without permission from the gender therapist.

- Where I live insurance companies pay for transition. We have a different system with mandatory healthcare. However you do need to go through the routine procedures to get stuff covered.

I would travel abroad to get the surgery, but I can´t afford either the travel costs or the surgery costs.

[WolfNightV4X1]

Oh, I see.

im not gonna say your system is better than ours because youre clearly struggling out of frustration and pain and that does suck. You shouldnt have to wait so long to work out the obvious.

Still, I kind of wish I could go through it if for the sake of insurance covered surgeries, honestly my expectation is I probably have to work myself into extra debt I have to pay down or savings before I get surgery, and it sucks to have to pay out of pocket for pricey surgeries. That wait will probably be 3-4 years down the road, or longer, assuming I stay financially stable and work my ass off. Dont see any other way to get that kind of help.

For your sake I hope the surgeon can take it without the therapist, that seems like a really nice light at the end of the tunnel

[November Fox]

I understand that.

Both having to wait years to transition and having to pay for your own surgery kind of suck. I appreciate that I live in a country where they pay for surgeries. Don´t forget that I pay a fair sum of money each month plus something called "personal risk", though.

Still, I have heard that surgeries in the states are way more expensive than here. If we could exchange nationalities for just a few years, you could have your surgery covered and I could go the way of informed consent... sadly it doesn´t work that way!

[Kylo]

It's taking longer than I thought. I don't wonder if it's partly to cover up the fact NHS services are stretched that they made me wait longer for surgery referral again. In any case I was told it would be "faster" once the supervising doctor OK's everything... that is the HRT and so on... but it's not proven to be the case. That was over 6 months ago now and they keep wanting me to speak to a therapist as a gateway even after HRT. Frustrating.

[November Fox]

It is frustrating. My gender therapist has said that I need to go through "real life experience" before I can even get okayed for surgery.

Which is so ridiculous because I´ve been officially male for six months and living as male for three years

I hope things speed up for you.

[jentay1367]

Certainly not to jack your thread, but I've often wondered if the Doctors that are paid for privately are the same ones that are part of the NHS system.  Cuz' if they are and the only reason they wont help or see you in a timely manner is your not giving them cash, well.......that seems unethical bordering on criminal. They either have time or don't.  Cash shouldn't advance you in their cue. Its Britain for crying out loud, not some third world backwater like the USA.   Or am I wrong and some Doctors don't play with the National Health at all?

[Kylo]

It is frustrating. My gender therapist has said that I need to go through "real life experience" before I can even get okayed for surgery.

Which is so ridiculous because I´ve been officially male for six months and living as male for three years

I hope things speed up for you.

Perhaps that's what they expect me to do... they say I've done it already but I'm not entirely sure what the gatekeeping specialist doctor wants from me at this stage. Maybe a damn buzz cut will do it. I don't know.

[Elis]

It is frustrating. My gender therapist has said that I need to go through "real life experience" before I can even get okayed for surgery.

Which is so ridiculous because I´ve been officially male for six months and living as male for three years

I hope things speed up for you.

Unfortunately you can only prove 'RLE' by the date you legally changed your name. So those 3 years don't really count

[Charlie Nicki]

And yes, that attitude is exactly the reason why it is taking me so long, but I refuse to conform to ideas people have, when those ideas are incredibly damaging.

I completely understand where you're coming from. Just wanted to share something my therapist said: Sometimes we need to be strategic. Sure, fighting the system will probably make you feel like you're doing things right and will also make you feel accomplished, but it can also take a lot of time, effort and mental energy. So just put both options in a balance and decide what's best for you. Sometimes we have to choose our battles.